| Special features of subarachnoid hemorrhage of unknown origin: a review of a series of 179 cases. | |
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MedLine Citation:
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PMID: 22196868 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVES: The aim of this study was to work out the special features of subarachnoid hemorrhage (SAH) of unknown origin in respect of diagnostic evaluation, clinical course, and outcome in a large cohort of patients. METHODS: We reviewed the data of 179 patients with SAH of unknown origin during 1991 and 2008. The differentiation between perimesencephalic (PM-SAH) and non-perimesencephalic SAH (NON-PM-SAH) was done under consideration of the bleeding pattern on CT scanning. RESULTS: Among 1226 treated patients with spontaneous SAH over a time period of 17 years, a bleeding source remained undetected on first digital subtraction angiogram (DSA) in 179 patients (16·7%) - 47 PM-SAH (26·3%) and 132 NON-PM-SAH (73·7%). The clinical signs of patients with PM-SAH were less marked compared to those with NON-PM-SAH, equally to the Hunt and Hess grade. magnetic resonance imaging (MRI) and MR angiography had 100% negative findings for non-aneurismal bleeding sources in all patients. Second DSA revealed a bleeding source in the NON-PM group in 10·8%. The clinical course of the patients with NON-PM-SAH showed a significantly higher rate of complications and a mortality of about 10%. The outcome was excellent in the PM group, in contrast to a fatal course in 13 cases in the NON-PM group. DISCUSSION: PM-SAH imposed with a mild clinical course and an excellent outcome, without severe complications. In contrast to this, NON-PM-SAH has a significant higher rate of dreaded complications and mortality. It is crucial to make an exact diagnosis of PM-SAH, considering CT scanning during the first 24 hours after occurrence of symptoms and the radiological features. |
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Authors:
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Homajoun Maslehaty; Harald Barth; Athanassios K Petridis; Alexandros Doukas; Hubertus Maximilian Mehdorn |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Neurological research Volume: 34 ISSN: 1743-1328 ISO Abbreviation: Neurol. Res. Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2011-12-26 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7905298 Medline TA: Neurol Res Country: England |
Other Details:
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Languages: eng Pagination: 91-7 Citation Subset: IM |
Affiliation:
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University Hospitals Schleswig-Holstein, Campus Kiel, Germany. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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